Maternal and fetal outcome in antepartum haemorrhage: a study at tertiary care hospital

Dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV) are arboviruses that can affect maternal and fetal outcome if acquired during pregnancy. This study was done to estimate the positivity of DENV, CHIKV, and ZIKV in febrile pregnant women attending a tertiary care hospital in north India. Symptomatic pregnant women were tested for these viruses by IgM ELISA and/or by Trioplex real-time polymerase chain reaction. Their symptoms and laboratory parameters were recorded and were followed up till delivery to know their immediate delivery outcome. Of 104 women tested, 50 (48.1%) were positive for viral markers. Of these, evidence of infection by DENV, CHIKV, and both was found in 34 (32.7%), 10 (9.6%), and 6 (5.8%), respectively. ZIKV was not detected in any woman. Maximum DENV positivity occurred in the third trimester of pregnancy and in women residing in urban than rural areas. Chills and rigors, arthralgia, retro-orbital pain, anemia, and vaginal bleeding were more commonly associated with DENV positivity. Backache, arthralgia, jaundice, and vaginal bleeding were more common in CHIKV positives but the difference between positives and nonpositives regarding these symptoms was not statistically significant. Dengue infections were associated with more frequent hospitalizations (OR = 8.38, 95% confidence intervals [CI] = 3.29–21.30) and mortality (OR = 19.0, 95% CI = 1.01–357.10). Hence, to conclude, in India wherever possible, all symptomatic pregnant women should be screened for DENV, CHIKV, and ZIKV as part of sentinel surveillance for ZIKV.

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Maternal and Fetal Outcome in Intrahepatic Cholestasis of Pregnancy in a Multicultural Society Conducted at a Tertiary Care Hospital in Dubai

Dubai Medical Journal ◽

10.1159/000513717 ◽

2021 ◽

pp. 1-7

Author(s):

Nighat Aftab ◽

Saima Faraz ◽

Komal Hazari ◽

Faiza Badawi Mahgoub

Keyword(s):

Gestational Diabetes ◽

Intrahepatic Cholestasis ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Fetal Outcome ◽

P Value ◽

Care Hospital ◽

Intrahepatic Cholestasis Of Pregnancy ◽

Fetal Outcomes ◽

Cholestasis Of Pregnancy

Introduction: Intrahepatic cholestasis of pregnancy (ICP) has been sparsely studied especially in the Middle East. The incidence and outcome of ICP varies worldwide. Its incidence in the Middle East and primary maternal and fetal outcome must be evaluated to ascertain the burden so that appropriate preventive and intervention measures can be formulated and implemented. Objective: To assess the incidence, associations, and maternal-fetal outcomes in ICP. Design: Case-control study. Settings: tertiary care hospital settings affiliated with the academic center in the UAE. Patients and methods: a total of 150 patients were included from October 2016 to September 2018 in the study with 75 cases of ICP and 75 controls matched according to age and date of delivery. The maternal risk factors attributable to ICP were recorded. Biochemical profile of mothers was monitored. Maternal and fetal outcomes were compared in 2 groups. Main outcomes measured: incidence and associations of ICP were evaluated. Maternal and fetal outcomes were compared in cases and controls. Sample size: 150. Result: The incidence of ICP in our study in the UAE was 1.0%. ICP has significant association with past obstetric cholestasis history (p value <0.01, odds ratio [OR] 9.3, 95% CI: 2.1–41.8), gestational diabetes (p value <0.05, OR 2.0, 95% CI: 1.0–3.8), pre-eclampsia (p value <0.05, OR 7.2, 95% CI: 1.6–33.1), and undergoing induction of labor (p value <0.01, OR 8.1, 95% CI: 3.7–17.8). The maternal bile acid level above 40 μmol/L is associated with higher chances of preterm delivery (p value <0.01, OR 8.2, 95% CI: 3.0–22.5), intrauterine fetal demise (p value <0.01), low birth weight (p value <0.01, OR 13.6, 95% CI: 4.2–43.5), respiratory distress (p value <0.05, OR 15.5, 95% CI: 1.8–132.7), poor Apgar score (p value <0.05, OR 12.720, 95% CI: 1.5–111.4), and NICU admissions (p value <0.01, OR 9.0, 95% CI: 1.8–45.9). Conclusion: ICP mothers have low incidence in the UAE and significant association with gestational diabetes and pre-eclampsia. High maternal bile acids above 40 μmol/L have poor fetal outcomes.

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Incidence of umbilical cord around the neck and its eﬀects on mode of delivery and fetal outcome at tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205924 ◽

2021 ◽

Author(s):

S. Nandhini ◽

C. R. Anuradha ◽

S. Renuka ◽

K. Vijayalakshmi ◽

R. Sailatha

Keyword(s):

Umbilical Cord ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Mode Of Delivery ◽

Fetal Outcome ◽

Fetal Membranes ◽

Control Group ◽

Care Hospital ◽

Exclusion Criteria ◽

Nuchal Cord

Background: Umbilical cord is one of the fetal membranes. It is developed from the yolk sac. Umbilical cord is tubular structure. Approximate length of the cord is 50 cm. Umbilical cord around the neck is called as the nuchal cord. The aim of the study is to find out the incidence of umbilical cord around the neck at the time of delivery and its fetal outcomes.Methods: It is a retrospective observational study. This study was conducted in the department of obstetrics and gynecology at a tertiary care hospital over a period of 6 months (Feb-Jul 2020). Out of 542 patients, 388 were enrolled in this study after the inclusion and exclusion criteria, of which 101 were delivered with umbilical cord and the remaining were 287 patients in control group.Results: Present study showed 38.4% incidence of umbilical cord at the time of delivery. Incidence is more among the primigravida and it is statistically significant. Both intrapartum and postpartum risks are not related to umbilical cord around the neck. Mean length of the cord in patients delivered with cord around the neck is more when compared to the control group and has significant p value.Conclusions: This study concludes that the presence of umbilical cord, alone is not an indication for caesarean section. Umbilical cord with 3 loops was associated with increased operative delivery and low Apgar score, proper intrapartum surveillance and portogram leads to good fetal outcome.

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Impact on fetal outcome following burns in pregnancy

International Surgery Journal ◽

10.18203/2349-2902.isj20211806 ◽

2021 ◽

Vol 8 (5) ◽

pp. 1454

Author(s):

Harsh Rajeev Mehta ◽

Pravinkumar P. Wasadikar

Keyword(s):

Surface Area ◽

Body Surface Area ◽

Body Surface ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Fetal Outcome ◽

Reproductive Age ◽

High Rate ◽

Care Hospital ◽

Burn Patients

Background: The incidence of female burn patients of reproductive age varies from 0.6%-15% in different series with highest incidence reported from India.Foetus is at high risk due to burns injury, which is often associated with a high rate of fetal mortality.Methods: All cases of burns injury encountered during pregnancy admitted at our tertiary care hospital were included in this study over a span of two years from 2017 to 2019. A total of 20 cases were included in the study. Patients with burns injury from 5 to 100% body surface area were included in this study.Results: Fetal deaths occurred in 11 out of the total 20 cases amounting to 55% overall fetal mortality.Conclusions: Burns during pregnancy requires adequate resuscitation especially in initial stages. There is 100% fetal death outcome for burns greater than 50% body surface area.

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Analysis of labor induction in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20204823 ◽

2020 ◽

Vol 9 (11) ◽

pp. 4627

Author(s):

Meenakshi Tanwar ◽

Anjali Choudhary ◽

Shweta Mishra

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Fetal Outcome ◽

Health Sciences ◽

Care Hospital ◽

Obstetric Outcome ◽

Lower Segment ◽

Normal Delivery ◽

Lower Segment Caesarean Section ◽

Labour Room

Background: Induction of labour (IOL) is a very common labour room procedure. Although labor is a natural physiological process, deliberate intervention in the form of induction may be required in many instances. It is needed in almost 20% of pregnant women for a variety of indications. The objective is to evaluate indications, different methods, and feto-maternal outcome of induced labour in tertiary care hospital.Methods: This was a retrospective study of IOL conducted in the department of obstetrics and gynecology, Shri Guru Ram Rai institute of medical and health sciences, Dehradun, Uttarakhand. Women who underwent IOL beyond 28 weeks gestation with single cephalic presentation with no contraindication for vaginal birth were included in the study. Statistical analysis was done with Microsoft excel.Results: A total of 1532 women delivered in the hospital during the study period. Among them, 498 women were induced (32.5%). Most common method of induction was misoprostol (40.36%) followed by prostaglandin E2 gel (26.90%). Out of 498 inductions, 377 women delivered vaginally making success of induction around 75.70%. Among them, 335 women had normal delivery (67.26%) and 42 women required instrumental delivery (8.4%) and 121 women underwent lower segment caesarean section (LSCS) (24.29%).Conclusions: Elective inductions of labor in properly selected indications at optimized timings aid in achieving a favorable maternal and fetal outcome. Methods of inductions, timing and intrapartum monitoring plays an important role in influencing obstetric outcome.

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